Laserfiche WebLink
(SHADED At _TO DE FILLED IN FOR THE `-ST TANK ONLY) <br /> Ip L If <br /> G OWNER NAME OWNER PHONE N <br /> E <br /> N CONTRACTOR CON'.' PHONEN <br /> E <br /> R SJLHD PRRMIT tl - PA N FIRE PERMIT N :) < ) T ; <br /> L � 9 <br /> INSPECTOR <br /> R RINSED (Y/N) METHOD i RINSE AMOUNT <br /> I 'k=nlsc� <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST N -OR- OTHER <br /> i <br /> AV VAPORS PURGED �Y/N) METHOD C \l 4_e( AMOUNT USED 17S_, <br /> ,S 12 � <br /> P L.E.L. READING AT REMOVAL (MUST Bk . < 2.0%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL 'uFTEEL.; FIBERGLASS, OTHER) TANK SI'ZE� -• <br /> / O TANK CONDITION�tjjOOD. POOR, HOLES) <br /> P N <br /> I S" PIPE MATERIAL , EEL), FIBERGLASS, OTHER) N. FEET <br /> P T <br /> I PIPING CONDITION (GOOD, POORP HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE N <br /> T <br /> F At'I l C`�'n '- T:C +.'' r` '1:. n d-,; 5 <br /> E K - <br /> L <br /> D EXCAVATION SIZE: _?- X 2= XI ) YDS OF SOIL: <br /> S- <br /> I A DEPTHSOIL TYPE OBSERVATION SAMPLE N <br /> N M P <br /> S P I <br /> P L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION X X YDS OF SOIL <br /> I — <br /> O H DEPTH TO G.W. : FT SAMPLING METHOD <br /> N <br /> 0 N OF HOURS SINCE DEWATERING: <br /> 2 OTHER SAMPLE: <br /> LABORATORY: ? F SAMPLERS NAME:" <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE . <br />